Free candform.indd - Wyoming

Statement of Formation By Candidate's Campaign Committee
W.S. 22-25-101(b) This form can be accessed on the Secretary of State's WEBSITE at: http://soswy.state.wy.us/Forms/FormsFiling.aspx Do you currently have a campaign committee that has not yet terminated? If yes, Name of Committee Name of New Committee Mailing Address E-mail Address Website Name of Chairman Phone Date Formed Name of Treasurer Yes No

(Must be separate individuals)

Residence Address Mailing Address Phone E-mail Address Complete the Appropriate Statement: Committee formed before an election to support the following candidate: Name and Party Affiliation Office Sought Committee formed after an election to defray campaign expenses for the following candidate: Name and Party Affiliation Office Sought I certify that I have examined this statement, and to the best of my knowledge and belief, it is true, correct and complete.

Signature of Chairman or Treasurer
3/2009 candform

Date See reverse side for instructions

A candidate is not required to have a candidate's campaign committee. However, if two or more persons as defined below wish to form a committee, the instructions follow:

INSTRUCTIONS
1. Candidate's Campaign Committee Defined - W.S. 22-1-102 (a)(vii) "Candidate's Campaign Committee" means every group of two or more persons who join together for the purpose of raising, collecting or expending money to be used in the aid of the election of a specific candidate for public office. If more than one committee forms to support the candidate, the candidate shall designate which committee shall be his or her principal campaign committee. 2. Organization of a Candidate's Campaign Committee - W.S. 22-25-101(b) A statement of formation is required when a candidate's campaign committee is formed, whether before the election to aid in the campaign or formed after an election to defray campaign expenses. The statement of formation shall include: (a) (b) (c) (d) name and mailing address of the committee; name and residence address of committee chairman and treasurer, who must be separate individuals; date committee formed; and the purpose of the committee.

3. Filing Date - W.S. 22-25-101(b) Within ten (10) days after formation. 4. Amendments to Statement of Formation - W.S. 22-25-106(e) File amendments to reflect any changes. 5. Filing Office - W.S. 22-25-107 County Clerk Secretary of State Candidates for district attorney, county and municipal offices, magistrates, school and community college district trustees. Candidates for state legislature, statewide office, circuit court, district court or supreme court.

6. Penalties - W.S. 22-26-112(a)(ix) (a) Unless a different penalty is specifically provided in this code, the following acts, if knowingly and willfully committed, are misdemeanor offenses punishable by not more than six (6) months in a county jail or a fine of not more than one thousand dollars ($1,000), or both: (ix) Violating W.S. 22-25-101 through 22-25-115.